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More than 556 million people receive treatment for lymphatic filariasis in
2015
Six formerly endemic countries recognized for eliminating the
disease as public health problem
05 October 2016 | Geneva Data recently published by the World Health
Organization (WHO) show that more than 556 million people worldwide were
treated for lymphatic filariasis in 2015, compared with 538 million in 2014.
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Through national elimination programmes we targeted nearly 698 million
people for treatment last year said Dr Gautam Biswas, Coordinator of the
Preventive Chemotherapy and Transmission Control unit of WHOs
Department of Control of Neglected Tropical Diseases. As of early
September 2015, just above 556 million were treated, which represents
coverage of more than 79% of the targeted population. Although this is a
great achievement, we know much more is needed to reach WHOs 2020
Roadmap targets.
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Elimination of lymphatic filariasis is possible by stopping the spread of the
infection.
Clinical severity and progression can be reduced and prevented with simple
measures of hygiene, skin care, exercise, and elevation of affected
limbs.GSK/MoH Indonesia
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WHO recommends annual treatment of all eligible populations in endemic
areas with a single dose of two medicines: albendazole (400 mg) together with
either ivermectin (150200 g/kg) or diethylcarbamazine citrate 1 (6 mg/kg).
Their effect reduces the density of microfilariae in the blood and prevents the
spread of parasites to mosquitoes.
Large-scale treatment, or preventive chemotherapy, conducted annually for
at least 5 years can interrupt transmission. Implementation of this strategy
has reduced numbers of infections in the community; in 18 countries levels
are so low that preventive chemotherapy can be stopped. By implementing
surveillance and providing care to affected patients, six of these countries 2
have demonstrated the elimination of the disease as a public health problem 3.
By conducting transmission assessment surveys, national programmes can
now determine whether to stop large-scale treatments. The survey results in
2015 revised down the population at risk of lymphatic filariasis in many areas
where interventions occurred several times: the global number of people
requiring treatment reduced from 1.4 billion in 2011 to 946 million in 2015.
Preventive chemotherapy is still required in 54 countries but has not been
delivered to all endemic areas as of the end of 2015. Enhanced strategies are
called for in about 29 countries to achieve the elimination targets and stop
treatment by 2020.
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Achieving elimination as a public health problem is not an end in itself
said Dr Jonathan King, scientist and focal point for lymphatic filariasis
elimination at WHOs Department of Control of Neglected Tropical Diseases.
Continued surveillance is crucial as is the integration of morbidity
management and disability prevention activities into public health systems
as part of continued care to alleviate the suffering of people affected by this
disease.
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Surgery can alleviate hydrocele (scrotal swelling) associated with the infection.
Clinical severity and progression of the disease, including acute inflammatory
episodes, can be reduced and prevented with simple hygiene measures, skin
care, exercise and elevation of affected limbs. People with lymphoedema must
have access to continuing care throughout their lives, both to manage the
disease and to prevent its progression to more advanced stages.
Since 2000, a cumulative total of 6.2 billion treatments has been delivered to
affected populations. The establishment that year of the Global Programme to
Eliminate Lymphatic Filariasis (GPELF) has resulted in the prevention or cure
of more than 97 million cases of lymphatic filariasis. This achievement is
projected in turn to avert more than US$ 100 billion in economic losses of
those who have benefitted from these treatments worldwide.
To achieve the WHO Roadmap targets for 2020, access to a minimum package
of care must be assured for every person with associated chronic
manifestations of lymphatic filariasis in all areas where the disease is present.
The aim is to alleviate suffering and promote improvement in the quality of
life of those affected.
Lymphatic filariasis is a parasitic disease that can result in an altered
lymphatic system. Manifestation of the disease after infection takes time and
can cause the abnormal enlargement of body parts leading to severe disability
and social stigmatization. The parasites are transmitted by four main types of
mosquitoes: Aedes, Anopheles, Culex and Mansonia.
1
DEC fortified salt for household use has been used as a public health tool in
China and other countries against bancroftian and brugian filariasis as it can
reduce infection levels below elimination thresholds. It is also one of the
WHO-recommended strategies against lymphatic filariasis.2Cambodia, Cook
Islands, Maldives, Niue, Sri Lanka and Vanuatu.3A process of validation is
used to formally confirm elimination as a public health problem. Countries
wishing to be recognized for their success can make a request to WHO for
such acknowledgement along with submission of a dossier.